ENHANCED ACTIVITY OF SYMPATHETIC RENAL NERVES IN HYPERTENSIVE PATIENTS WITH UNILATERAL RENAL ISCHEMIA - ITS RELATIONSHIP TO PLASMA-RENIN ACTIVITY IN RENAL VENOUS-BLOOD

In 16 hypertensive patients with significant unilateral renal artery s tenosis plasma renin activity (PRA) and plasma levels of adrenaline (A ), noradrenaline (NA) and dopamine were assessed in arterial blood, re nal venous blood of the ischemic (IK) and normally (NK) perfused kidne y and in blood withdrawn from the inferior vena cava, distally from th e orifices of the renal veins. Plasma levels of A (= 661.8 +/- 187.7 p g/ml) and NA (= 396.3 +/- 72.5 pg/ml) in renal venous blood of the isc hemic kidney were significantly greater than in renal venous blood of the normally perfused kidney (A = 123.4 +/- 16,0 pg/ml; NA = 277.2 +/- 55.6 pg/ml) and than in arterial blood (A = 68.44 +/- 8.4 pg/ml; NA = 192.8 +/- 28.9 pg/ml) and inferior vena cava blood (A = 67.8 +/- 7.5 p g/ml; NA = 182.6 +/- 26.8 pg/ml). In contrast to A and NA, plasma D le vel in renal venous blood of the normally perfused kidney was signific antly higher (= 27,9 +/- 4,9 pg/ml) than in renal venous blood of the ischemic kidney (= 14.3 +/- 2.1 pg/ml) and than in arterial blood (= 1 6.1 +/- 1.9 pg/ml) and in blood of the inferior vena cava (= 16.3 +/- 1.8 pg/ml). A significant positive correlation was found between PRA a nd plasma levels of A and NA respectively only in renal venous blood o f the ischemic kidney. From results obtained in this study it follows, that hypertensive patients with significant unilateral renal artery s tenosis are characterized by enhanced activity of sympathetic renal ne rves and that sympathetic overactivity of renal nerves may be related to enhanced generation of angiotensin II in the ischemic kidney.